NEW YORK (Reuters Health) Jan 29 - New research indicates that the plasma level of NT-proBNP is a better prognostic indictor than the glomerular filtration rate (GFR) estimated with standard equations in patients with advanced heart failure.
As reported in the European Heart Journal for December, Dr. Roy S. Gardner, from the Royal Infirmary in Glasgow, UK, and colleagues assessed NT-proBNP levels and GFR (estimated with the modification of diet in renal disease equations) in 182 patients with advanced heart failure who were being considered for cardiac transplantation. The median follow-up period was 642 days.
During follow-up, 40 patients died, 4 required urgent cardiac transplantation, and another 29 underwent non-urgent transplantation.
On univariate analysis, GFR predicted all-cause mortality. On multivariate analysis, however, only the NT-proBNP level was a significant independent predictor of all-cause mortality or the combined endpoint of all-cause mortality or urgent transplantation.
The current study "represents an important step forward regarding the utility of NT-proBNP testing in patients with impaired renal function," Dr. James L. Januzzi, from Massachusetts General Hospital in Boston, and colleagues write in a related editorial.
The findings indicate that NT-proBNP "is strongly prognostic for death and/or urgent cardiac transplantation even in the presence of renal impairment," they add.
Eur Heart J 2008;28:2960-2961,3027-3033.